ObjectiveTo evaluate the correlation of matrix metalloproteinase-9 (MMP-9) and lipoprotein associated phospholipase A2 (Lp-PLA2) levels on admission with short-term prognosis and hemorrhagic transformation (HT) in patients with acute ischemic stroke treated with thrombolysis.

MethodsA total of 65 acute ischemic stroke patients treated with rt-PA intravenous thrombolysis were selected.Demographics, disease severity, the MMP-9 and Lp-PLA2 levels on admission and HT were prospectively recorded.Multivariate logistic analysis was used to evaluate the correlation between MMP-9, Lp-PLA2 and other baseline data with short-term prognosis and HT.ROC curve analysis was used to analyze the predictive value of MMP-9 and Lp-PLA2 levels for prognosis.

ResultsThe levels of serum MMP-9 and Lp-PLA2 in the poor prognosis group were significantly higher than those in the good prognosis group (P < 0.01).The most significant risk factors for poor prognosis were MMP-9, Lp-PLA2 and NIHSS score before thrombolysis (P < 0.05 to P < 0.01).The age, NIHSS score before thrombolysis, MMP-9 and Lp-PLA2 levels were the high risk factors for HT after thrombolysis (P < 0.01).The most significant risk factors for HT were age, MMP-9, Lp-PLA2 and NIHSS score before thrombolysis (P < 0.05 to P < 0.01).The ROC curve analysis showed that the area under the curve of MMP-9 predicting poor prognosis was 0.773 (95%CI: 0.649-0.898), the cutoff value was 163.65 ng/mL, the sensitivity was 88.6%, and the specificity was 73.3%.The area under the ROC curve of Lp-PLA2 was 0.705 (95%CI: 0.574-0.836), the cutoff value was 244.20 ng/mL, the sensitivity was 82.9%, and the specificity was 83.3%.

ConclusionsThe levels of MMP-9 and Lp-PLA2 are independent predictors for short-term prognosis after rt-PA intravenous thrombolysis in acute ischemic stroke patients, and relate to intracerebral hemorrhage transformation.